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Obesity Surgery
Published in: Obesity Surgery 9/2019

01-09-2019 | Obesity | Multimedia Article

Modified Sleeve Gastrectomy Combined with Laparoscopic Rossetti Fundoplication and Vascularization Assessment with Indocyanine Green

Authors: Stefano Olmi, Giulia David, Giovanni Cesana, Francesca Ciccarese, Riccardo Giorgi, Stefano De Carli, Matteo Uccelli

Published in: Obesity Surgery | Issue 9/2019

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Abstract

Aim

Morbid obesity is a key risk factor for gastroesophageal reflux; the aim of this study is to describe the technique of modified laparoscopic Rossetti fundoplication to treat morbid obesity related to GERD.

Methods

This is a video/dynamic manuscript on operative technique. We present the case of a 38-year-old patient referred to our institution for morbid obesity (BMI 43 kg/m2) related to GERD symptoms with grade A esophagitis at the preoperative upper gastro intestinal endoscopy and in daily therapy with PPI since years. The patient was scheduled for a laparoscopic sleeve gastrectomy combined with Rossetti fundoplication.

Results

Intraoperative and postoperative course were uneventful. One year later, the BMI is 27.9 kg/m2 and at clinical and endoscopic follow-up demonstrates absence of esophagitis and any PPI therapy is needed.

Conclusion

The modified sleeve gastrectomy combined with laparoscopic Rossetti fundoplication seems to be a safe, effective procedure and a suitable alternative to gastric bypass in obese patients with GERD.
Appendix
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Literature
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Herbella FA, Sweet MP, Tesesco P, et al. Gastroesophageal refux disease and obesity. Pathophysiology and implications for treatment. J Gastrointest Surg. 2007;11:286–90.CrossRefPubMed
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Wu JC, Mui LM, Cheung CM, et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132(3):883–9.CrossRefPubMed
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Hendricks L, Alvarenga E, Dhanabalsamy N, et al. Impact of sleeve gastrectomy on gastroesophageal reflux disease in a morbidly obese population. Undergoing bariatric surgery. Surg Obes Relat Dis. 2016;12:511–7.CrossRefPubMed
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Olmi S, Caruso F, Uccelli M, et al. Laparoscopic sleeve gastrectomy combined with Rossetti fundoplication (R-sleeve) for treatment of morbid obesity and gastroesophageal reflux. Surg Obes Relat Dis. 2017;13(12):1945–50.CrossRefPubMed
Metadata
Title
Modified Sleeve Gastrectomy Combined with Laparoscopic Rossetti Fundoplication and Vascularization Assessment with Indocyanine Green
Authors
Stefano Olmi
Giulia David
Giovanni Cesana
Francesca Ciccarese
Riccardo Giorgi
Stefano De Carli
Matteo Uccelli
Publication date
01-09-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03970-w

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